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Care of the Patient with a Fractured Neck of Femur Presenter: Fiona Nielsen

Innovation Poster Session HRT1215 – Innovation Awards Sydney 11 th and 12 th Oct 2012. Care of the Patient with a Fractured Neck of Femur Presenter: Fiona Nielsen. Hospital Austin. 3-3a_HRT1215-Session_NEILSON_AUSTIN_VIC. KEY PROBLEM.

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Care of the Patient with a Fractured Neck of Femur Presenter: Fiona Nielsen

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  1. Innovation Poster Session HRT1215 – Innovation Awards Sydney 11th and 12th Oct 2012 Care of the Patient with a Fractured Neck of FemurPresenter: Fiona Nielsen Hospital Austin 3-3a_HRT1215-Session_NEILSON_AUSTIN_VIC

  2. KEY PROBLEM Polaris had a longer length of stay (36%) for DRG 108 than exemplar health services. We could save a potential 700 bed days by matching exemplar health services. But We all went to look at the care we were delivering to this particularly vulnerable group of patients. The clinicians and the executive, walked through the steps of patient’s journey to see for themselves. When we met together afterwards we all knew – we could do better than this: Variable care delivery Inadequate and unmonitored pain relief Delays to theatre Prolonged and unmonitored fasting Peri operative complications - delirium

  3. AIM OF THIS INNOVATION Provide quality care to this patient group, focus on what really matters. Reduce variation in care delivery – ‘every patient, every time’. Reduce variation in our systems –Patients to theatre within 48 hours Manage fasting times- No patient to fast longer than 12 hours All patients to have their pain managed and monitored All patients assessed and monitored for delirium

  4. BASELINE DATA- Long length of stay Long delays to theatre and unclear plans led to prolonged fasting

  5. KEY CHANGES IMPLEMENTED Hunger Clock. Counts down patient fasting time. 12 hour tolerance – if the patient does not have a firm plan then the fast is broken Patients to theatre within 48 hours Early detection and treatment of delirium Perioperative Pain Plan. All patients receive full pain management.

  6. OUTCOMES SO FAR And Ongoing Most patients to theatre in 24 hrs, all within 48 hrs

  7. LESSONS LEARNT Hospitals are Frogs- not Bicycles.-Alistair Mant Also Stay the course, don’t listen to No Consider the use of Failure Effects Analysis Mode, before final roll out of any intervention Clinical and executive leadership and support are essential, but support the project lead and staff too. Configure your Steering Committee and then have them delegate representatives for you to work with Excellence will do, perfection will burn you out

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